Impact of suspected violence against adults in health outcomes. A retrospective cohort study

Abstract

Background: Violence has an extensive and profound impact on health, representing a public health problem. Different health outcomes have been identified based on the personal characteristics of both the victim and the abuser, their relationship, the type of violence perpetrated, and the cumulative effect of multiple violent experiences throughout a person's life. Objective: The main objective of this study is to estimate the likelihood of health-negative outcomes occurring in adults presenting a clinical suspicion of experiencing interpersonal violence. The specific aims are to identify the different health outcomes: health risk behaviours, and mental health and somatic conditions.

Methods: We performed a real-world, retrospective, observational, and analytical cohort study, using secondary data from electronic health records and health registries of adult users of the Local Health Unit of Matosinhos, who were considered suspected victims of interpersonal violence, over a 10-year follow-up period. Data was obtained based on the International Classification of Diseases (ICD-9 and ICD-10), and International Classification of Primary Care (ICPC-2). and clinical notes, according to defined keywords. Results: The control cohort included 154 145 cases and the violence cohort included 36 835 cases. Globally, adult suspected victims of interpersonal violence had a higher likelihood of developing health risk behaviours and mental health and somatic conditions. We highlight the potential link found between adult violence and Non-alcoholic Fatty Liver Disease (NALFD) with a likelihood 6.9 times higher in adult victims of violence compared to those who were not (HR = 6.91, 95% CI = [6.37-7.50]). Conclusions: Our findings lead to a deeper understanding of the complex burden of violence in health, uncovering new relationships between violence and health outcomes while revalidating the already explored. Ultimately, our study contributes to improving prevention, intervention, and treatment strategies.